Journal of Ultrasound in Medicine, Vol 17, Issue 6 369-372, Copyright © 1998 by American Institute of Ultrasound in Medicine
Simple cyst in the postmenopausal patient: detection and management
C. Conway, I. Zalud, M. Dilena, D. Maulik, H. Schulman, J. Haley and K. Simonelli
Department of Obstetrics and Gynecology, Winthrop University Hospital, Mineola, New York, USA.
The aims of our study were to determine the prevalence of simple ovarian
cysts in asymptomatic postmenopausal patients and to investigate the
natural history of these cysts by ultrasonographic follow-up examinations.
Three thousand five hundred and eighty-five women participated in the
volunteer pelvic cancer screening program. Entry criteria were as follows:
postmenopausal, no clinical symptoms, and no previous gynecologic
pathology. An anechoic, small cyst less than 5 cm in greatest diameter was
classified as a simple ovarian cyst. A scoring system to determine
malignant potential had been established previously. All simple cysts had a
score of 2 or less and had a morphology typical of benign lesions. In the
case of a positive finding, the patient would be seen at 3 to 6 month
intervals. The decision for surgical intervention was made by a private
gynecologist or patient or if an interval change was noted. One thousand
seven hundred and sixty-nine postmenopausal women (49.34% of all patients
from the screening program) participated in this study. One hundred and
sixteen simple cysts were found, with a prevalence of 6.6% in our
population. Among those patients, 27 (23.28%) simple cysts resolved
spontaneously, 69 (59.48%) have persisted, and 20 (17.24%) have been lost
to follow-up study. Eighteen women (26.09%) with persistent simple ovarian
cyst underwent surgery. No malignant ovarian conditions were identified. In
conclusion, simple ovarian cysts are more common in postmenopausal women
than previously was thought. This condition is very unlikely to be
malignant and can be followed conservatively.
